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European Archives of Oto-Rhino-Laryngology

, Volume 252, Issue 8, pp 491–494 | Cite as

An external approach without tracheotomy for submucosal cordectomy with laterofixation for bilateral abductor paralysis of the vocal folds

  • Z. Milutinović
Original Paper

Abstract

There are numerous surgical procedures now available to manage bilateral abductor paralyses of the vocal folds. These procedures have various success rates but mostly do not offer reliable and predictable postoperative results, and usually require ,tracheotomy. The technique described in this report is based on a trial study to obtain a safe airway for an affected patient and avoid tracheotomy, if possible. Submucosal cordectomy was used with lateral fixation of one vocal fold and preservation of the arytenoid. The procedure was performed by using continuous intravenous anesthesia, which does not require intubation of the patient's airway. Seven patients were operated with this technique with excellent postoperative results. The glottal airway was largely improved in all patients, with only minor temporary complications.

Key words

Bilateral vocal fold abductor paralysis Submucosal cordectomy Lateral fold fixation 

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References

  1. 1.
    Crumley RL (1993) Endoscopic laser medical arytenoidectomy for airway management in bilateral laryngeal paralysis. Ann Otol Rhinol Laryngol 102:81–84PubMedGoogle Scholar
  2. 2.
    Dennis DP, Kashima H (1989) Carbon dioxide laser posterior cordectomy for treatment of bilateral vocal cord paralysis. Ann Otol Rhinol Laryngol 98:930–934PubMedGoogle Scholar
  3. 3.
    Eckel HE (1991) Laser surgical microlaryngoscopic glottis dilatation in the treatment of recurrent bilateral nerve paralysis. Surgical technique and results. Laryngorhinootologie 70:17–20PubMedGoogle Scholar
  4. 4.
    Ejnell H, Mansson I, Hallen O, Bake B, Stenborg R, Lindstrom J (1984) A simple operation for bilateral vocal cord paralysis. Laryngoscope 94:954–958PubMedGoogle Scholar
  5. 5.
    Freche C (1984) La voix humaine et ses troubles. Librairie Arnette, Paris, pp 198–203Google Scholar
  6. 6.
    Kelly JD (1941) Surgical treatment of bilateral paralysis of the abductor muscles. Arch Otolaryngol 2:293–304Google Scholar
  7. 7.
    King BT (1939) A new and function-restoring operation for bilateral abductor cord paralysis. Preliminary report. JAMA 112:314–323Google Scholar
  8. 8.
    annigan FJ, Robb PJ, Alderson DJ, Shaheen OH (1991) Carbon dioxide laser cordectomy in the management of bilateral vocal cord paralysis. J R Coll Surg Edinb 36:378–380PubMedGoogle Scholar
  9. 9.
    Lawson HP (1959) Bilateral abductor paralysis of the vocal cords. In: Rob C, Smith R (eds) Operative surgery: eyes, ears, nose and throat. Davis, PhiladelphiaGoogle Scholar
  10. 10.
    Lichtenberger G (1983) Endo-extralaryngeal needle carrier instrument. Laryngoscope 93:1348–1351PubMedGoogle Scholar
  11. 11.
    Lim RY (1985) Laser arytenoidectomy. Arch Otolaryngol 111:262–263PubMedGoogle Scholar
  12. 12.
    Lore JM (1936) A suggested operative procedure for the relief of stenosis in bilateral abductor paralysis: an anatomic study. Ann Otol Rhinol Laryngol 45:679–684Google Scholar
  13. 13.
    Lore JM Jr (1988) An atlas of head and neck surgery. Saunders, Philadelphia, pp 880–881Google Scholar
  14. 14.
    Merite-Drancy A, Laccourreye O, Brasnu D, Laccourreye H (1992) Partial posterior cordectomy with laser CO2 in bilateral recurrent paralysis. Ann Otolaryngol Chir Cervicofac 109:235–239PubMedGoogle Scholar
  15. 15.
    Muermann Y (1953) Extended cordectomy for intrinsic laryngeal carcinoma; application and results: plastic covering of excision surface. Proceedings of the 5th International Congress on Otorhinolaryngology, AmsterdamGoogle Scholar
  16. 16.
    Ossoff RH, Duncavage JA, Shapshay SM, Krespi YP, Sisson GA Sr (1990) Endoscopic laser arytenoidectomy revisited. Ann Otol Rhinol Laryngol 99:764–771PubMedGoogle Scholar
  17. 17.
    Rontal M, Rontal E (1990) Endoscopic laryngeal surgery for bilateral midline vocal cord obstruction. Ann Otol Rhinol Laryngol 99:605–610PubMedGoogle Scholar
  18. 18.
    Thornell WC (1948) Intralaryngeal approach for arytenoidectomy in bilateral abductor vocal cord paralysis. Arch Otolaryngol 47:505–508Google Scholar
  19. 19.
    Tucker HM (1977) Reinnervation of the unilaterally paralyzed larynx. Ann Otol Rhinol Laryngol 86:789–794PubMedGoogle Scholar
  20. 20.
    Tucker HM (1982) Nerve-muscle pedicle reinnervation of the larynx: avoiding pitfalls and complications. Ann Otol Rhinol Laryngol 91:440–444PubMedGoogle Scholar
  21. 21.
    Tucker HM, Ogura JH (1971) Vocal cord remobilization in the canine larynx: an histologic evaluation. Laryngoscope 81:1602–1606PubMedGoogle Scholar
  22. 22.
    Woodman D (1946) A modification of the extralaryngeal approach to arytenoidectomy for bilateral abductor paralysis. Arch Otolaryngol 43:63–65Google Scholar

Copyright information

© Springer-Verlag 1995

Authors and Affiliations

  • Z. Milutinović
    • 1
  1. 1.Department of Otolaryngology, “Zemun” Clinical Hospital CenterUniversity of Belgrade Medical SchoolZemun-BelgradeSerbia

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